DIME - Test Summary

Summary for Test 2021-08-30-27-4

Test performed: SMTL BILST-06

Project Identifiers	Project ID: 215516 DEA: 042Q0604 EFIS: 0418000414
DIST-CO-RTE-PM	04-SCL-17,101,237,280,880-var
Award Date	04/20/2021
Closeout Date	03/27/2023
Work Description	PLACE POLYESTER CONCRETE OVERLAY, PLACE HMA, AND REPLACE ACCESS DOORS.
Location Description	SANTA CLARA COUNTY AT VARIOUS LOCATIONS
QA Service Level	1 (Verified on 03/02/2021)

Sample Taken Date	08/30/2021	Sample Unique Key	27
Date that the sample was received by the laboratory/organization performing the testing	09/03/2021	Sample type	Quality Assurance
A brief description of the sample	bearing pad	The quantity of what the sample constitutes	1
From where was the sample collected	Manufacturer	First name of sampler or witnessed by	Patrick
Last name of sampler or witnessed by	Loomis	Title of sampler
Telephone number of sampler		Laboratory sample identification
Linked DIME Sample ID		The fabricator/manufacturer/facility name	Scougal Rubber
Transportation Laboratory (TL) Number		Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier		Structure name
Bid Item	Not set

Material Type	SMTL TM1 - Elastomeric Bearing Pad	Mfg. Lot Number(s)	20482-1
Material/Compound/Elastomer ID	na	Samples Representing	11
Description (size)	1.15"x10"x10"	Comments
Description (Number of Shims)	2	Type of Bearing Pad	Steel
Description (Thickness of Shims)	14 gage	Manufacturer(s)	Scougal Rubber
Batch Number	na

DIME Sample ID: 2021-08-30-27

DIME Test ID: 2021-08-30-27-4

Testing Lab: CT HQ - Sacramento Chemistry Laboratory

Test Method: SMTL BILST-06: (Neoprene Verification) Bilstein Test

Test Release Date: 2021-09-13

Input Type: Measured

Tester's full name: Rachael Chavez

Date of test: 09/13/2021

Result: Pass

General comments (publicly viewable) (Max 1000 characters):

Test was verified on 9/13/2021 ✔